Transcatheter Aortic Valve Replacement (TAVR)
A team of physicians including cardiologists and cardiovascular surgeons at the Orlando Health Heart Institute, began offering this breakthrough procedure, providing hope for patients whose quality of life was compromised by the symptoms of aortic stenosis.
The procedure is called transcatheter aortic valve replacement (TAVR) and was approved by the United States Food and Drug Administration in November 2011 to treat patients with aortic valve stenosis who are not considered candidates for traditional open heart surgery.
TAVR was developed for the thousands of people suffering from aortic valve stenosis who were not considered candidates for traditional open heart surgery because their overall health was not stable enough to sustain the stress. This procedure potentially gives them an opportunity to live longer, without symptoms.
During the procedure, which is performed on a beating heart, a small incision is made in the femoral artery (main blood vessel in your groin) through which a catheter will be inserted to reach your aortic valve. The catheter has a balloon on the end that is inflated to stretch open your narrowed aortic valve. The new valve, made up of a stent (stainless steel webbing) and biological tissue taken from cows, is then compressed and mounted to a second balloon catheter and also inserted through the femoral artery to the aortic valve. Once properly positioned in the valve, the balloon is inflated to implant the new aortic valve.
After the catheters are removed and your incision closed, another incision is made in the vein in your groin, through which a small wire is directed to your heart. An electrical impulse is then passed through the wire to speed up your heart rate to about 200 beats per minute for just a few seconds. This reduces the blood pressure and motion of the heart, making it easier for the TAVR valve to settle in the proper position. The pacing wire will be removed immediately or at a later time, depending on the surgeon’s decision. The whole procedure takes 2-3 hours.
See how the TAVR Procedure is Performed:
Aortic Valve Stenosis
Aortic valve stenosis is the term used when the aortic valve is narrowed, interfering with the amount of blood able to flow out of the heart and to the rest of the body. Causes of aortic valve stenosis include:
- A valve abnormality the patient was born with (congenital)
- “Wear and tear” of the valve
The presence of this condition places an extra strain on the heart and may affect the circulation of blood throughout the body. This can result in breathlessness and fluid retention – which can cause swollen ankles and legs. Chest pain, dizziness and fainting are also side effects of aortic valve stenosis.
There are no medications that can reverse aortic valve stenosis, however, your doctor may prescribe certain medications to help your heart once you have developed symptoms. These medications may include diuretics (water pills), medications to lower your blood pressure, or to lower your cholesterol and medications to control heart rhythm disturbances associated with aortic valve stenosis. No medication has been proven to prolong your life once you develop symptoms from aortic stenosis—in general, once a patient has developed symptoms from aortic stenosis, surgical intervention is needed to replace the valve.
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